Seeds Care Limited

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

People were not always protected from avoidable harm because risk assessments were not always clear, comprehensive and up to date. This was an area for improvement. Staff and leaders were able to identify situations that amounted to safeguarding and staff were confident to use the whistleblowing process if needed. Staff knew people well and were able to identify changes to health and identify care and support needs. Lessons were learned when things went wrong. Medicines were administered and recorded safely. Medicines practice to understand when to administer PRN (as and when required medicines) required improvement, the management team took immediate action to address this. Staff were recruited safely and were supported through training, there was a plan in place to make sure they had ongoing support in the form of supervision and appraisal meetings. There were enough staff to support people safely. Ongoing training made sure that staff had the skills needed to support people. Accidents and incidents were reviewed and actioned by the management team, safety checks undertaken by staff. The provider had systems and processes in place to detect and control potential risks in the care environment and processes in place to assess and manage the risk of infection.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

People communicated that they felt safe, and that staff knew how to protect them from risks. They trusted staff to keep them safe. People told us sometimes they worried about things. They said that if this happened they spoke to a member of staff who listened and talked with them and this made them feel safe. One relative told us, “All policies and practices at the home are centred around safeguarding and the welfare of the young people in their care."

Staff had been given some incorrect guidance on safeguarding. We asked the provider to investigate an incident. In the discussion with staff it was found that staff had incorrectly been told by a previous senior staff member that if a person bit their hand this did not constitute self-harm. The provider guided staff to record any similar incidents appropriately so people’s health and well-being could be monitored accurately. Staff understood what safeguarding was and how to escalate concerns.

We observed people were familiar with staff which helped them to relax and feel safe. When people were going out, staff ensured people had everything with them they needed to help keep them safe.

The organisation had a safeguarding procedure in place. During the assessment the safeguarding procedure was updated as it did not provide working links to the local authorities safeguarding policy, procedure and protocol which staff required access to. The provider's safeguarding processes were not fully robust. The provider is required to notify CQC about specific events including safeguarding. Prior to our assessment visit there had been a delay in sending some notifications to us in a timely manner. During this assessment visit we found the provider had not sent us a notification about a person who had absconded, and threatened self-harm resulting in the police being called.

Staff knew people well and responded to people’s risks in an individual way. People were encouraged to pursue their interests, develop and maintain relationships and to be a part of their community through positive risk taking. People told us how important it was that staff enabled them to take part in lots of activities and events that they enjoyed outside of their home. A persons daily records showed progression in their involvement in daily life. The person had early experience of trauma at the barbers. The staff had brought in a mobile hairdresser who visited the person at their home monthly. They worked hard to gain the persons trust and the person was enjoying having their hair cut.

Staff knew people well. They described strategies used to prevent people becoming anxious. For example, telling people clearly what was going to happen and what they could expect to reduce their anxiety. Staff could recognise the signs when people experienced emotional distress and knew how to support them safely. They described what situations or circumstances could trigger people to become upset and the best ways to support them. Staff understood the health needs of people and what triggers people might display if becoming unwell, and how to reduce further deterioration. Care plans were detailed and the staff had worked at the service with people for several years.

People had been involved in practising evacuating their homes in case of an emergency. They were able to tell us and show us where they would evacuate to if they needed to. We observed that people were supported to manage their community safety risks well.

There were systems to assess and manage people’s risks however these were not robust. Although the majority of risk assessments contained information to guide staff about how to minimise identified risks to people, there was some inconsistency in this practice. For example, some people were at risk of self harm. For people at risk of self harm through cutting their wrists, no assessment had been made of the risk of them accessing sharp objects which they could use to harm themselves. The provider confirmed during this assessment they had updated the risk assessments and risk checklists to highlight the potential risks and to reflect the actions taken to minimise them. Other people's risk assessments identified individual risks and provided information for staff to support people to manage and monitor the risks, including accessing the community, shopping, menu planning, cooking, and included personal likes and dislikes. The organisation had health and safety procedures in place and routine checks and maintenance was in place. Each person had a personal emergency support plan. This gave guidance that would be shared with the emergency services to support quick and effective evacuation in an emergency.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

People told us there were enough staff available so they could go out and do the things that they wanted to do. A relative told us, “[loved one] is provided with a high level of support virtually 24/7. [Loved one] is happy in the home and illustrates when I see him that he feels safe in that environment.”

Staff told us they received a comprehensive induction, including shadowing experienced staff and undertaking essential training before working on their own. Staff had undertaken training in a wide range of strengths and impairments people with a learning disability and or autistic people may have. Staff felt the training they had was adequate for their role. However, some staff had received face to face emergency epilepsy medicines training and other staff had completed training through a video call, which staff said did not make them feel confident and did not include assessing if they were competent to administer the medication. The provider confirmed during the assessment that practical training was being rolled out to ensure staff were skilled and competent in this area. Staff received email reminders when further training and updates were due. Most training was completed online, no staff identified they had any additional training needs.

We observed there were enough staff deployed on shift in in each of the supported living properties. This included one-to-one support, for people to take part in activities in their home, to go out and to complete daily living tasks. Staff were responsive to people, did not rush them and took time talking and listening to people.

The recruitment process ensured safe recruitment practice was followed. Designated 1-1 time was allocated in accordance with funded hours. There was a system to ensure the correct numbers were deployed. Staff had been safely recruited. People receiving care and support had been involved in recruiting staff. We examined 3 staff files and all of the required checks had been carried out and documents were all in date. The provider had a central system in place which ensured that all recruitment checks were completed before a staff member started. These included copies of references, interview notes, photographic identification and Disclosure and Barring Service forms (DBS). DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. The provider's induction policy did not include information or reference to The Care Certificate. This is an agreed set of standards that define the knowledge, skills and behaviours expected of specific job roles in the health and social care sectors. The Care Certificate is made up of the 15 minimum standards that should be covered if staff are new to care and should form part of a robust induction programme. We spoke with the nominated individual about this and they amended their policy to ensure the induction policy was more robust.

People communicated to us that they had support from staff with a range of daily chores. Between them and with staff oversight, all the cleaning within each supported living house was managed. Floors were mopped nightly by the night staff.

Staff told us that each person had a weekly list of chores, staff provided oversight to ensure people were managing their own cleaning in their individual rooms and communal areas. Staff told us they had plenty of Personal Protective Equipment (PPE) to wear when supporting with personal care to keep themselves and people safe. Staff told us they had received infection prevention and control training.

We observed that PPE was used by staff appropriately and there was plenty of stock. There was a yellow bin for any clinical waste/body fluids, and general black bin for other waste, collected weekly. The supported living houses we visited were clean, hygienic and well ventilated. The fridges and freezers were set at the correct temperatures and food was stored safely and wrapped appropriately.

The provider had systems and processes in place to assess and manage the risk of infection. They were able to detect and control the risk of it spreading and share any concerns with appropriate agencies promptly. There was a daily cleaning program in place. Care staff supported people to carry out daily cleaning, cleaning schedules were in place. Infection control audits were completed regularly and actions taken if any issues were found. The provider had plenty of PPE in place to keep people and staff safe. The kitchen areas were clean.

People received their medicines safely. A person said, "Staff have really helped with my skin. They put all the creams on and my skin is now amazing.” Care plans showed another person prompted staff when they were ready to have their medicines. People's medicines information were in an easy to read format with large pictures. Staff used this information to help people understand the medicine, the dose and any side effects that could occur.

People received their medicines from trained staff. The staff informed us they received training. The management team told us staff were competency assessed to handle medicines safely. All staff felt confident to administer medicines and had received appropriate training and had been deemed competent. Team leaders carried out regular spot checks to ensure medicines practice was safe and following policies and procedures. Staff told us they supported people to reorder medicines 2 weeks in advance to ensure people did not run out. People were supported to collect their medicines from the pharmacy. Staff told us about STOMP (Stopping over medication of people with a learning disability and autistic people) and the importance of evaluating the efficacy of medication taken. Staff understood what the PRN (as and when required medicines) protocols were for each person.

We observed that staff followed safe medicines practices. They ensured medicines were locked away securely and gave people their medicines in the privacy of people’s bedrooms.

The provider had systems and processes in place to manage medicines. Some improvements were identified. Some people were prescribed medicines to be taken only when required known as (PRN) medicines. Guidance (PRN protocols) were in place to help staff give these medicines consistently. There was a medicine policy in place, however this was not always followed. A person’s high risk medicine had guidance about when it should be administered. It was general rather than specific stating that it should be given when the person was in ‘a heightened state’. The day after our assessment visit, the nominated individual for the provider confirmed the PRN protocol now contained individualised and specific guidelines for staff to ensure this medicine was administered as intended by their GP. Each person had their own medicine folder. Folders contained a recent photograph of the person and correctly completed medicine administration records (MAR). MAR record entries were signed, dated and those medicines that required a second signature had these in place. Stock counts of medicines showed medicines had been accounted for. Folders contained a hospital passport, a short summary of key health and social support needs to be used in an emergency.